Department of Surgery, Temple University School of Medicine, 3401 North Broad Street, Parkinson Pavilion, Suite 400, Philadelphia, PA 19140, USA.
Surg Clin North Am. 2011 Aug;91(4):787-803, viii. doi: 10.1016/j.suc.2011.04.013.
Patients with inflammatory bowel disease (IBD) in need of surgery are often malnourished, which in turn increases the risk for postoperative complications. Malnutrition in IBD patients who must undergo surgery is due to the disordered activity of the diseased intestine, decreased dietary intake, and adverse effects of potent medications. IBD operations predispose patients to both macronutrient and micronutrient deficiencies. If the gut can be used safely it is the preferential route for feeding, though preoperative and postoperative parenteral nutrition remains a viable alternative for severely malnourished patients. New nutrient therapies include immunonutrition, fish oils, and probiotics.
患有炎症性肠病(IBD)并需要手术的患者通常存在营养不良,这反过来又增加了术后并发症的风险。患有 IBD 且必须接受手术的患者出现营养不良是由于疾病肠道活动紊乱、饮食摄入减少以及强效药物的不良影响。IBD 手术使患者容易出现宏量营养素和微量营养素缺乏。如果肠道可以安全使用,它是首选的喂养途径,尽管术前和术后肠外营养仍然是严重营养不良患者的可行选择。新的营养治疗包括免疫营养、鱼油和益生菌。